Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

There is a question about transparency, although I am not pointing the finger at anybody. A number of aspects of the response to Covid-19 do not add up for people. One such matter is the fact that the test numbers are so low. People have heard for many weeks that we should be doing 15,000 tests a day, but that is not happening. In fact, the numbers are very low, which calls into question the whole strategy and which questions some of the data being used. Clearly, we are operating off theoretical models rather than real-time data. When people listen to the information every evening, they cannot figure it out because it does not seem to make a lot of sense. I appeal to the authorities to level with the public. The public has kept with the Government, the health authorities and so on. They have stuck with the measures and been remarkably co-operative but it is important there is absolute transparency and clarity in respect of the data. Where serious problems arise, they should be explained. There are worldwide shortages of different products that are required, and that needs to be explained to people rather than being glossed over. The more data the public get, the better, and the more upfront everyone is in telling people frankly what the situation is, the better. As for the figure of 15,000 tests, the strategy is not working unless we are doing that level of testing.

We cannot get to a point where we can consider lifting the restrictions until we have that level of testing. I know what some of the difficulties are and I raised with the Taoiseach earlier the issue of intervening with regard to the reagent. At this point, what is the Minister's estimate of how soon we will get to the point where end-to-end testing will be done at the level of about 15,000 per day?

The other point on data relates to the situation in nursing homes. It is a matter of regret that it took until last Friday night to get a figure for the number of deaths in nursing homes. That should not have been the case. We now know that more than half of the total number of deaths - approximately 54% - took place in nursing homes and other residential settings but those figures were not being provided. As I said, last Friday night for the first time we got the figure for the number of deaths in nursing homes. What we need to be getting on a regular basis is data on the number of deaths in nursing homes and the number of deaths in hospital of residents of nursing homes. We also need data on the number of deaths in disability centres and there is some very concerning news coming out today in that regard. It should not be the case that we are depending on individual reporters for information on deaths in disability centres and mental health settings. I have given the Minister notice of seeking such figures now and I hope he can provide them but I also appeal to him to arrange for such figures to be provided on a regular basis so that we get a full picture of what is happening, the scale of the challenge and what the response needs to be.

There is also an issue with the figures we get on clusters. To say that there are 206 clusters, or whatever, is not very helpful. We need to know if these are small clusters of just two people, or clusters of between five and ten people, ten and 20 people and so on. It would be very helpful if we had a breakdown of those figures which would inform the response that needs to happen. There is another data-related issue which I have written to the HPSC about but I have not received a reply yet. The data deals with different age cohorts in terms of prevalence and death rates but once we reach 65, the remaining cohort is 65 plus. I do not know what the rationale for that is but we should be getting data for those aged 65 to 74, 75 to 84 and 85 plus. I ask the Minister to pursue that to see if such data can be provided.

My final question is on nursing homes. I have written to the Minister and to HIQA about this. What protocols are being followed when a nursing home resident contracts Covid-19? Who decides, and on what basis, whether that person is sent for treatment in an acute hospital or remains in the nursing home? These are legitimate decisions but who takes them? Are they taken by clinicians? If a decision is taken for the person to remain in the nursing home, are we in a position to provide palliative care? Is palliative care being provided in those circumstances? The issue in nursing homes is exposing the weaknesses in how we provide services, as it has done in a number of different areas. There has been a tendency in recent years to privatise a lot of services and disconnect them from the public health service. Sometimes these nursing homes are regarded as investment opportunities rather than care centres and things are cut to the bone in terms of staffing levels. In that context, I have a real concern that there is not adequate palliative care available for those patients who sadly will remain in nursing homes and see out their days as victims of Covid-19 in those settings. I would appreciate answers to those questions.

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